Euthanasia, Islam & Christianity

A review of Islam, Euthanasia and Western Christianity: Drawing on Western Christian Thinking to Develop an Expanded Western Sunni Muslim Perspective on Euthanasia, by Rishad Raffi Motlani.

In his doctoral dissertation, Rishad Motlani scrutinizes the positioning of selected Christian and Muslim ethicists concerning euthanasia. He analyzes and classifies the sorts of argumentation chosen by those authors and engages with them critically. His comparison aims at fleshing out methodological overlaps, similarities as well as differences – an undertaking which he explicitly also conceptualizes as a contribution to interfaith dialogue.

In Chapter 1, “Terms, Issues and Positions in the Euthanasia Debate,” the author gives a highly readable overview of terms and definitions of euthanasia. This is pivotal since very fine nuances are decisive in this discussion. The “Doctrine of Double Effect” (DDE) receives considerable attention, which refers to the ethical problem of certain methods of palliative care which aim at alleviating pain on the one hand but might have the effect of shortening the life span of the patient under treatment.

In Chapter 2, “Selected Western Christian Perspectives on Euthanasia,” Motlani presents the views of Michael Banner, Pope John Paul II, Nigel Biggar, and Joseph Fletcher. These authors were chosen because their texts are accessible in English and they constitute a spectrum of opinions ranging from staunch opposition against Euthanasia (Banner) to its endorsement (Fletcher). The author shows how Banner, author of the influential Christian Ethics and Contemporary Moral Problems (Cambridge: Cambridge University Press, 1999), bases his argument on Western Christian anthropology combining it with a strong anti-consequentialist stand. John Paul II emphasizes the concept of a special dignity of human life, from which a duty of its protection “in all reasonable circumstances” (p.46) is derived. By contrast, in Nigel Biggar’s view on the topic the view of humans as social beings is pivotal (see Nigel Biggar, Aiming to Kill: the Ethics of Suicide and Euthanasia. Cleveland: Pilgrim Press. 2004). According to him the ability to serve mankind is decisive. If this is lost, e.g. through loss of biographical life as opposed to biological life, the value of human life diminishes. However, he opposes a relaxation of British anti-euthanasia laws with the consequentialist argument that this might lead to a decrease of respect for human life. The permissive stance towards euthanasia of Joseph Fletcher, who developed situational ethics, is primarily based on consequentialist thinking and a negative evaluation of pain.

In Chapter 3, “Selected Islamic Perspectives on Euthanasia,” Motlani analyzes three views. First a non-Muslim perspective authored by Jonathan Brockopp, second the perspective of three Iranian medical doctors and ethicists Farzaneh Zahedi, Bagher Larijani and Javad Tavakoly Bazzaz (referred to as Zahedi et al.), and finally the view of US-American Muslim ethicist Abdulaziz Sachedina. These authors were by and large selected along the same criteria as the authors analyzed in the previous chapter. According to Motlani, Brockopp takes a Western utilitarian viewpoint on Islamic sources and ends up arguing that “passive” as well as “active” euthanasia could be allowed by drawing on these sources. While Motlani concurs concerning “passive euthanasia,” i.e. the withdrawal of treatment for terminal patients, he takes issue with Brockopp’s publication concerning “passive euthanasia.” Pivotal in this is the question of how to interpret Qur’an Sura 4, Verse 29, which can be understood either as “Do not kill yourselves, for surely God is merciful to you” or as “Do not kill each other…”. The first interpretation argues for an explicit Qur’anic prohibition of suicide while the latter posits the verse in discussions about intra-religious conflicts. Eminent authors in the history of exegesis of the Qur’an such as Fakhr al-Din al-Razi (d. 1209) or Muhammad Sayyid Tantawi (d. 2010) opted for the latter interpretation, and al-Razi can even be understood to have argued for the permissibility of suicide in cases of severe suffering. Zahedi et al. use consequentialist thinking to argue for the permissibility of “passive” euthanasia and provide more room for the element of patient autonomy within limits, while they are strictly opposed to “active euthanasia” as well as prolonging life indefinitely. Abdulaziz Sachedina opposes consequentialist thinking and focuses on “the nature and significance of suffering” in the Islamic normative context, largely arriving at the same position as Zahedi et al. concerning “passive” and “active” euthanasia.

In Chapter 4, “Western Christian and Islamic Viewpoints: A Comparative Discussion,” Motlani systematically reviews the two previous chapters according to principles which are being used by the respective authors referring to different religious texts and traditions. These are largely consequentialist and anti-consequentialist arguments, while the latter are sub-divided into traditional practices and dogmatic principles relating to religious anthropology respectively. Interesting parallels are references, for example, to the role of suffering by several thinkers and respect for the time of death predetermined by God. Differences can be detected in the way how Christian and Muslim authors argue for a sacredness of human life. In the Christian tradition the concept can be derived from the idea of humans being created in the image of God, a concept which cannot be transferred to Islamic tradition, according to Motlani.

In Chapter 5, “An Extended Western Sunni Islamic Account of Euthanasia,” adds material to the debate partly drawing on work by Sunni Muslim religious scholars which is directly related to end-of-life issues, but mostly aiming at adding new lines of argumentation to the debate. For example, Islamic acts of worship are viewed as bodily practices which can be interpreted as specific ways of respecting the body. This in turn can serve as a basis for the argument that euthanasia collides with the principle of respect for the human body.

This valuable dissertation will expand the field of interfaith dialogue as well as bioethical deliberations on euthanasia from inter-religious perspectives.